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Volume 43(6); December 2013
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Review Article
Validity of Instrument Development Research in Korean Nursing Research
Kyunghee Lee, Sujin Shin
J Korean Acad Nurs 2013;43(6):697-703.   Published online December 31, 2013
DOI: https://doi.org/10.4040/jkan.2013.43.6.697
AbstractAbstract PDF
Purpose

This integrative review study was done to analyze methods used for validation studies in Korean nursing research.

Methods

In this study, the literature on instrument development in nursing research from Research Information Sharing Service (RISS) and major nursing journal databases in Korea were examined. The MeSH search terms included 'nursing', 'instrument', 'instrument development', 'validation' and 189 articles were included in the review.

Results

The most frequently reported validity type was content validity, followed by construct validity, and criterion validity. One third reported a single type of validity, and 15% of the studies demonstrated three kinds of validity at the same time. In about 40% of the studies, both content and construct validity were examined.

Conclusion

The results of the study indicate that it is necessary to provide a wider variety of evidence to establish whether instruments are valid enough to use in nursing research.

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Original Articles
Mothers' Parenting Experience of Premature Infants: Q Methodological Approach
Mi-Young Chon, Eun Sun Ji, Shin-Hwa Lee
J Korean Acad Nurs 2013;43(6):704-713.   Published online December 31, 2013
DOI: https://doi.org/10.4040/jkan.2013.43.6.704
AbstractAbstract PDF
Purpose

This study was done to identify the parenting experience of mothers of premature infants in order to provide basic data for educational solutions and desirable directions.

Methods

Q-methodology was used as it provides a method of analyzing the subjectivity of each item. The participants were 33 mothers of premature infants who sorted 34 selected Q-statements which were then classified into the shape of a normal distribution using a 9-point scale. Subjectivity on parenting experience among the mothers was analyzed using the pc-QUANAL program.

Results

Four types of parenting experience were identified. Type I was named 'struggling', type II, 'self blame', type III, 'information collecting', and type IV, 'self-introspection'.

Conclusion

The results of this study indicate that different approaches to educational programs are needed for mothers of premature infants based on the four types of parenting experience.

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Construction of the Addiction Prevention Core Competency Model for Preventing Addictive Behavior in Adolescents
Hyun Sook Park, Sun Young Jung
J Korean Acad Nurs 2013;43(6):714-725.   Published online December 31, 2013
DOI: https://doi.org/10.4040/jkan.2013.43.6.714
AbstractAbstract PDF
Purpose

This study was done to provide fundamental data for the development of competency reinforcement programs to prevent addictive behavior in adolescents through the construction and examination of an addiction prevention core competency model.

Methods

In this study core competencies for preventing addictive behavior in adolescents through competency modeling were identified, and the addiction prevention core competency model was developed. It was validated methodologically.

Results

Competencies for preventing addictive behavior in adolescents as defined by the addiction prevention core competency model are as follows: positive self-worth, self-control skill, time management skill, reality perception skill, risk coping skill, and positive communication with parents and with peers or social group. After construction, concurrent cross validation of the addiction prevention core competency model showed that this model was appropriate.

Conclusion

The study results indicate that the addiction prevention core competency model for the prevention of addictive behavior in adolescents through competency modeling can be used as a foundation for an integral approach to enhance adolescent is used as an adjective and prevent addictive behavior. This approach can be a school-centered, cost-efficient strategy which not only reduces addictive behavior in adolescents, but also improves the quality of their resources.

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Effects of Aroma Massage on Pruritus, Skin pH, Skin Hydration and Sleep in Elders in Long-term Care Hospitals
So Young Roh, Kye Ha Kim
J Korean Acad Nurs 2013;43(6):726-735.   Published online December 31, 2013
DOI: https://doi.org/10.4040/jkan.2013.43.6.726
AbstractAbstract PDF
Purpose

The purpose of this study was to examine the effects of aroma massage on pruritus, skin pH, skin hydration and sleep in elders in long-term care hospitals.

Methods

The participants were elders over 65 years old admitted to long-term care. They were assigned to the experimental group (26) or control group (28). Data were collected from May to August, 2012. Visual Analogue Scale and Verran and Snyder-Halpern Sleep scale were used to identify levels of pruritus and sleep. A skin-pH meter and moisture checker were used to measure skin pH and skin hydration. Aroma massage was performed three times a week for 4 weeks for elders in the experimental group. The data were analyzed using the SPSS Win 17.0 program.

Results

There were significant differences in pruritus, skin pH and skin hydration between the two groups. However there was no significant difference in sleep.

Conclusion

The results indicate that aroma massage is effective in reducing pruritus, skin pH and increasing skin hydration in elders. Therefore, this intervention can be utilized in clinical practice as an effective nursing intervention to reduce pruritus in elders in long-term care hospitals.

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A Quality Assessment of Meta-Analyses of Nursing in South Korea
Jung-Hee Kim, Ae-Kyung Kim
J Korean Acad Nurs 2013;43(6):736-745.   Published online December 31, 2013
DOI: https://doi.org/10.4040/jkan.2013.43.6.736
AbstractAbstract PDF
Purpose

The purpose of the study was to assess the quality of meta-analyses on nursing published in South Korea.

Methods

Relevant meta-analyses were identified through searches of the National Assembly Library, KISS (Korean Studies Information Service System), and the DBpia and RISS4U databases from 1990 to May 2013. Quality assessments were conducted using AMSTAR, a validated tool for assessing the quality of systematic reviews.

Results

Forty-two meta-analyses were included in this study. Twenty-nine published between 1990 and 2010, and 13, between 2011 and May 2013. Two high quality studies and 11 moderate quality studies were published in the latter period. The mean score for the reviews was 5.61 (range 3-10); 11 studies were rated as low quality, 29 as moderate quality, and two as high quality.

Conclusion

Although an improvement in the quality of meta-analyses conducted by nursing researchers in South Korea was observed across the study period, the study results indicate a need to use of more rigorous research methods when conducting systematic reviews or meta-analyses.

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Systematic Review and Meta-Analyses of Diagnostic Accuracy of Infrared Thermometer when Identifying Fever in Children
Young Joo Park, Seong-Hi Park, Chang-Bum Kang
J Korean Acad Nurs 2013;43(6):746-759.   Published online December 31, 2013
DOI: https://doi.org/10.4040/jkan.2013.43.6.746
AbstractAbstract PDF
Purpose

Infrared thermometers are increasingly used as a convenient, non-invasive assessment method for febrile children. However, the diagnostic accuracy of the infrared thermometer for children has been questioned, particularly in relation to sensitivity and specificity. The aim of this study was to evaluate diagnostic accuracy of infrared thermometers in febrile children.

Methods

Articles published between 1966 and 2012 from periodicals indexed in the Ovid Medline, Embase, CINAHL, Cochrane, KoreaMed, NDSL, KERIS and other databases were selected, using the following keywords: 'infrared thermometer'. The QUADAS-II was applied to assess the internal validity of the diagnostic studies. Selected studies were analyzed using meta-analysis with MetaDisc 1.4.

Results

Nineteen diagnostic studies with high methodological quality, involving 4,304 children, were included. The results of meta-analysis showed that the pooled sensitivity, specificity and AUC (Area Under the Curve) of infrared tympanic thermometers in children over 1 year were 0.80 (95% CI 0.78, 0.81), 0.94 (95% CI 0.93, 0.95) and 0.95 respectively. However the diagnostic accuracy of infrared tympanic thermometers in children with hyperthermia was low.

Conclusion

The diagnostic accuracy of infrared tympanic thermometer was similar to axillary and rectal thermometers indicating a need for further research to substantiate these findings in children with hyperthermia.

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Factors Associated with Physical Activity among Chinese Immigrant Women
Sung-Hye Cho, Hyeonkyeong Lee
J Korean Acad Nurs 2013;43(6):760-769.   Published online December 31, 2013
DOI: https://doi.org/10.4040/jkan.2013.43.6.760
AbstractAbstract PDF
Purpose

This study was done to assess the level of physical activity among Chinese immigrant women and to determine the relationships of physical activity with individual characteristics and behavior-specific cognition.

Methods

A cross-sectional descriptive study was conducted with 161 Chinese immigrant women living in Busan. A health promotion model of physical activity adapted from Pender's Health Promotion Model was used. Self-administered questionnaires were used to collect data during the period from September 25 to November 20, 2012. Using SPSS 18.0 program, descriptive statistics, t-test, analysis of variance, correlation analysis, and multiple regression analysis were done.

Results

The average level of physical activity of the Chinese immigrant women was 1,050.06±686.47 MET-min/week and the minimum activity among types of physical activity was most dominant (59.6%). As a result of multiple regression analysis, it was confirmed that self-efficacy and acculturation were statistically significant variables in the model (p<.001), with an explanatory power of 23.7%.

Conclusion

The results indicate that the development and application of intervention strategies to increase acculturation and self-efficacy for immigrant women will aid in increasing the physical activity in Chinese immigrant women.

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Analysis of Factors Affecting Unmet Healthcare Needs of Married Immigrant Women
Su Hee Kim, Chung Yul Lee
J Korean Acad Nurs 2013;43(6):770-780.   Published online December 31, 2013
DOI: https://doi.org/10.4040/jkan.2013.43.6.770
AbstractAbstract PDF
Purpose

The purpose of this study was to identify the factors affecting the unmet healthcare needs of married immigrant women.

Methods

This study was a secondary data analysis using data from the 2009 National Survey of Multicultural Families. Data collected from 58,735 married immigrant women who had spouses were analyzed using descriptive statistics, Chi-square test, and logistic regression.

Results

Overall, 9.9% of married immigrant women have unmet healthcare needs. The significant predictors related to unmet healthcare needs were young age, high level of education, employed, country of origin, long period of residence, low income, uninsured, urban area, low level of subjective health status, and illness experience over past two weeks. In particular, four variables (long period of residence, low income, subjective health status, and illness experience over past two weeks) significantly predicted unmet healthcare needs for women from all countries of origin.

Conclusion

The results of the study indicate that common predictors related to unmet healthcare needs of married immigrant women are a long period of residence, low income, subjective health status, and illness experience over past two weeks. Therefore intervention strategies to decrease unmet healthcare needs should focus on these significant predictors.

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Experience in Acceptance of Hospice by Patients with Terminal Cancer : A Phenomenological Research
Su Young Kwak, Byoung Sook Lee
J Korean Acad Nurs 2013;43(6):781-790.   Published online December 31, 2013
DOI: https://doi.org/10.4040/jkan.2013.43.6.781
AbstractAbstract PDF
Purpose

The purpose of this study was to further understanding of the experience in acceptance of hospice by patients with terminal cancer and to explore the structure of this experience.

Methods

A phenomenological methodology was used for the study. Participants were nine patients who were admitted to the hospice unit of a university hospital. In-depth interviews were done for data collection and the data were analyzed using Colaizzi's method.

Results

Four categories, eight theme clusters and 18 themes were identified for the experience in acceptance of hospice by patients with terminal cancer. The three categories were 'Hope for a comfortable death', 'Overcoming barrier of prejudice about hospice', 'Incessant craving for life', 'The last consideration for self and family'.

Conclusion

While accepting the hospice care, participants experienced inner conflict between giving up medical treatments that prolong life and choosing a comfortable death, and also experienced an incessant craving for life. By accepting hospice care, they showed a human dignity that entails careful concerns for both self and family members.

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Structural Equation Modeling on Case Management Outcomes and Factors Influencing Outcomes in the Community-dwelling Vulnerable Elders
Hyunjung Moon, In-Sook Lee
J Korean Acad Nurs 2013;43(6):791-800.   Published online December 31, 2013
DOI: https://doi.org/10.4040/jkan.2013.43.6.791
AbstractAbstract PDF
Purpose

This study was done to test a structural equation modeling of case management outcomes in order to identify parameters affecting case management outcomes for the community-dwelling vulnerable elders.

Methods

Data were collected from 309 nurses (case managers) and community-dwelling vulnerable elders (clients) from public health centers. For data analysis, descriptive statistics, Pearson correlation analysis, factor analysis, and covariance structure analysis were performed using SPSS Version 18.0 for Windows and Amos 16.0.

Results

The hypothetical model had an acceptable fit: GFI=.97, CFI=.95, RMSEA=.02, SRMR=.05. The factor "case managers' singularity" had the greatest impact on case management outcomes in this model. In addition, the factor "case management practice" influenced case management outcomes; however, client characteristics did not. Case managers' singularity affected case management outcomes directly and indirectly, with case management practice mediating the latter effect.

Conclusion

These results suggest that the causal relationship between case management outcomes and factors influencing these outcomes should be clarified through longitudinal research including a variety of client characteristics. In addition, in future studies, analysis of the effects of programs to improve manpower quality and examine the relationships among case management outcomes should be done.

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Changes in Quality of Life and Related Factors in Thyroid Cancer Patients with Radioactive Iodine Remnant Ablation
Seon Hee Yoo, Smi Choi-Kwon
J Korean Acad Nurs 2013;43(6):801-811.   Published online December 15, 2013
DOI: https://doi.org/10.4040/jkan.2013.43.6.801
AbstractAbstract PDF
Abstract Purpose

To investigate changes in Quality of life (QOL) and related factors in patients with thyroid cancer undergoing Radioactive Iodine remnant ablation (RAI).

Methods

Data were collected longitudinally 3 times for 6 months (2 weeks post-surgery, post RAI, 3 months post RAI) in a hospital located in Seoul. Questionnaires were used to measure levels of physical symptoms, anxiety, depression, and QOL. Ninety-eight patients with thyroid cancer who had RAI were included in the analysis. Data were analyzed using SPSS (18.0).

Results

Findings for the three data collection times respectfully were: mean scores for physical symptoms, 0.53, 1.21 and 0.62, patients with depression, 47%, 36.7% and 37.7%, patients with anxiety, 18.4 %, 19.4% and 20.4%, mean scores for QOL, 7.06, 7.01 and 7.28. QOL score was highest 3 months post RAI (p=.031). In the stepwise multiple regression analysis, depression and fatigue were predicting factors for low QOL at all data collection times. Dysponia was a predicting factor for low QOL post RAI and 3 months post RAI.

Conclusion

To increase QOL, it is necessary to provide information in advance regarding physical & psychological symptoms and to develop nursing intervention programs to decrease depression and fatigue.

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Structural Relationship of Burnout and Related Variables among Family Caregivers of Cancer Patients
Min Joo Hong, Young Sook Tae
J Korean Acad Nurs 2013;43(6):812-820.   Published online December 31, 2013
DOI: https://doi.org/10.4040/jkan.2013.43.6.812
AbstractAbstract PDF
Purpose

The purpose of this study was to construct a structural equational model to explain and predict burnout in family caregivers of patients with cancer. The study was based on the Stress-Appraisal-Coping Model of Lazarus and Folkman (1984) and Family Stress Theory (Hill, 1958).

Methods

Data were collected from July 10 to September 30, 2012 through direct interviews and a self-report questionnaire survey. Participants in this study were 206 family caregivers providing care for patients with cancer in In-patient or Out-patient departments of three different general hospitals located in Busan. Measured variables were exogenous variables (social support and perceived health status) and endogenous variables (perceived stress, hope and burnout).

Results

Goodness of fit in the hypothetical model was χ2=174.07, TLI=.95, CFI=.97, RMSEA=.08. Perceived health status, perceived stress, and hope showed statistically significant direct effects on burnout of family caregivers. Social support affected burnout of family caregivers indirectly. These variables explained 68.5% of total variance in burnout.

Conclusion

The results from this study suggest that perceived stress, perceived health status, and hope should be considered as major influential factors when developing nursing interventions to control burnout of family caregivers (of patients with cancer).

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Corrigendum
Corrigendum
J Korean Acad Nurs 2013;43(6):821-821.   Published online December 31, 2013
DOI: https://doi.org/10.4040/jkan.2013.43.6.821
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